Anaemia and cancer treatment: a conceptual change.
Anaemia is the most common haematological abnormality in cancer patients, and unfortunately, it is often under-recognised and undertreated. The aetiopathology of anaemia in cancer patients is complex and is usually multifactorial. There is enough evidence suggesting that tumour hypoxia in anaemic patients has a negative impact on the treatment outcomes in cancer patients. The use of recombinant human erythropoietin is becoming a new standard of care in cancer patients. Various well-controlled studies have shown that the use of erythropoietin (EPO) increases the haemoglobin level, thereby decreasing the need for frequent transfusions and improving the tumour responses, cancer-free survival and quality-of-life parameters in cancer patients. However, a few recent clinical trials failed to replicate the survival benefit. Hence, a free unrestricted use of EPO is to be avoided. The past belief that anaemia does not matter in cancer patients is now considered invalid and is being seriously challenged. This article aims to present some recent findings on the impact of anaemia on outcomes, with discussion on the possible causes and effects. The benefits of the use of EPO analogues in cancer-related anaemia are also presented.
Khan
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FA
Department of Oncology and Radiotherapy, Advanced Medical and Dental Institute, Universiti Sains Malaysia, 29 Lorong Bertam Indah 4/9, Taman Bertam Indah 13200, Kepala Batas, Penang, Malaysia. fkhanmurad@hotmail.com
Shukla
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AN
Joshi
S C
SC
D000740:Anemia / Q000150:complications / Q000188:drug therapy*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D004921:Erythropoietin / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D000860:Hypoxia; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D011788:Quality of Life; D011994:Recombinant Proteins / Q000627:therapeutic use; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin